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Christina Ciaccio,1 Jessica Dunne,2 Andrea Bever,2 Karissa Johnston,2 Stacey Kowal,3 Arpamas Seetasith,3 Andrew Lloyd,4 Alexis Mickle2 1The University of Chicago, Chicago, IL, USA; 2Broadstreet Health Economics & Outcomes Research, Vancouver, British Columbia, Canada; 3Genentech, Inc., South San Francisco, CA, USA; 4Acaster Lloyd Consulting Ltd, London, UKCorrespondence: Christina Ciaccio, Department of Pediatrics and Medicine, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL, 60637, USA, Tel +1-773-834-4010, Email cciaccio@bsd.uchicago.eduPurpose: The quality of life (QoL) impact of food allergies extends beyond severe allergic reactions, as food avoidance can permeate the daily lives of individuals with food allergies and their caregivers. People with multiple food allergies may experience a greater impact on QoL than people with a single food allergy, but there is limited evidence available. The aim of the study was to provide insight into the lived experiences of adults, teenagers, children, and caregivers of children with multiple food allergies.Methods: Semi-structured interviews were conducted of people with multiple food allergies and their caregivers (n = 20) in the United States, including 10 adults, 5 teenagers, and 5 caregivers of children. Patterns in responses were explored using reflexive thematic analysis.Results: Four themes were developed by the researchers to convey the experiences of people with food allergies and QoL impact: preparedness and allergen avoidance results in a loss of spontaneity; emotional impact varies by person and for each person; participating in society involves speaking up and trusting others; and food is more than nutrition. In addition, 3 themes were identified that convey the experiences of caregivers: looking out for your child’s safety is an emotional balancing act; limitations on what you can do on your own and as a family; and creating a safe and fulfilling environment can be time-consuming and costly.Conclusion: These findings highlight that people with multiple food allergies experience social limitations, stress about food safety and allergen avoidance, and restrictions on freedom. Caregiver QoL is impacted by the need to navigate social, emotional, and practical implications of caring for a child with multiple food allergies.Plain Language Summary: People with food allergies must constantly make an effort to avoid the foods they are allergic to. Having an allergy to more than 1 type of food (for example, peanuts, eggs, or milk) can be even more difficult. In this study, we interviewed adults and teenagers with food allergies, as well as parents of children with food allergies, about how having an allergy to more than 1 type of food affects their daily lives. We found that people with more than 1 food allergy often had stress and anxiety. They also had to change the way they traveled or socialized. Parents caring for a child with food allergies were also impacted. Parents had to look out for their child’s safety and made changes to family plans and activities. The lives of people with food allergies and their families may be improved by treatments or interventions that can lower the risk of allergic reactions.Keywords: food hypersensitivity, quality of life, patients, caregivers, multiple food allergies

Joseph Elliot Alchin,1,2 Christina Signorelli,1,2 Jordana Kathleen McLoone,1,2 Claire Elizabeth Wakefield,1,2 Joanna Elizabeth Fardell,1,2 Karen Johnston,1 Richard J Cohn1,2 1Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia; 2School of Women’s and Children’s Health,UNSW Medicine, University of New South Wales, Sydney, NSW, AustraliaCorrespondence: Christina Signorelli, Kids Cancer Centre, Level 1 South, Sydney Children’s Hospital, High St, Randwick, NSW, 2031, Australia, Tel +61 431 547 350, Fax +61-2-9382-1789, Email c.signorelli@unsw.edu.auPurpose: Ongoing survivorship care allows childhood cancer survivors the opportunity to address treatment-related health problems and improve their quality of life. However, many survivors do not adhere to their healthcare professionals’ recommendations and the factors supporting their adherence remain unclear.Patients and Methods: Long-term childhood cancer survivors completed the “Re-engage” program, which assessed survivors’ heath needs and provided individualised recommendations for health interventions and surveillance developed by an expert multi-disciplinary team (MDT). We measured survivors’ recall of, and adherence to, their individualised healthcare recommendations at one and six months post-intervention. We conducted a series of univariate negative binomial regressions to investigate factors associated with the total number of recommendations that were correctly recalled and adhered to.Results: We analysed the data of 25 childhood cancer survivors who participated in Re-engage (mean age = 31.9 years). On average, survivors were provided with 6.6 recommendations (range = 1– 11). Survivors accurately recalled receiving 3.0 recommendations at one month post-intervention and 1.9 at six months. Survivors had adhered to an average of 1.3 recommendations by six-month follow-up. In total, 56% of participants reported that they did not adhere to any recommendations. By six-month follow-up, greater adherence to MDT recommendations was associated with having a history of a second cancer (B = 1.391; 95% confidence interval [CI], 0.686 to 2.097; p

Lok Sze Katrina Li,1 Catherine Paquet,2 Kylie Johnston,1 Marie T Williams3 1School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, 2Center for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, 3Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, AustraliaIntroduction: Intergenerational associations in chronic obstructive pulmonary disease (COPD) have been well recognized and may result from genetic, gene environment, or exposure to life course factors. Consequently, adult offspring of parents with COPD may be at a greater risk of developing COPD. The aim of this study was to review the prevalence of co-occurrence of COPD in adult offspring with one or both parents having COPD independent of specific genetic variations.Methods: In total, five databases were searched for original studies in which prevalence of COPD was reported in both offspring (children) and one or both parents. Studies were excluded if COPD was not clearly defined, COPD was linked to specific genetic variations, COPD was combined with other chronic respiratory conditions, or estimates included other first-degree relatives. Data extraction (ie, sample characteristics, prevalence of COPD, and odds ratio [OR] if reported) was completed by two independent reviewers. A meta-analysis of prevalence and OR was conducted, where possible. Results: Of the 3,382 citations, 129 full texts were reviewed to include eight studies (six case–control, one cross-sectional, and one cohort) reflecting either prevalence of COPD in offspring of parents with COPD (descendent approach, n=3), which ranged from 0% to 17.3%, or prevalence of people with COPD reporting positive parental history of COPD (antecedent approach, n=5), for which the pooled prevalence was 28.6%. Offspring of people with COPD had 1.57 times greater odds (95% confidence interval =1.29–1.93; P

Beth A Fordham,1 Cicely Kerr,1 Hayley M de Freitas,1 Andrew J Lloyd,1 Karissa Johnston,2 Corey L Pelletier,3 Gabriel Tremblay,3 Anna Forsythe,3 Bryan McIver,4 Ezra EW Cohen5 1ICON Patient Reported Outcomes, Oxford, UK; 2ICON Epidemiology, Toronto, ON, Canada; 3Eisai Inc., NJ, 4Moffitt Cancer Center, FL, 5University of California San Diego Moores Cancer Center, La Jolla, CA, USA Purpose: The aim of this study was to elicit utilities for radioactive iodine-refractory differentiated thyroid cancer (RR-DTC) and evaluate the impact of treatment response and toxicities on quality of life.Patients and methods: RR-DTC health states were developed based on data from a previous qualitative study and iterative review by clinical experts. Following piloting, health states underwent valuation by 100 members of the UK public during time trade-off interviews. Mean utilities and descriptive distribution statistics were calculated, and a logistic regression analysis was conducted.Results: The demographic characteristics of the study sample were generally reflective of the UK population. Clear differentiation in valuation between health states was observed. No response/stable disease had an adjusted utility value of 0.87, with a corresponding gain of +0.04 following a treatment response and a decline of –0.35 for disease progression. Adverse events were associated with utility decrements between –0.47 (grade III diarrhea) and –0.05 (grade I/II alopecia).Conclusion: The trade-off interviews derived utility weights show clear differentiation between RR-DTC health states in response to treatment. The values reported in this study are suitable for cost-effectiveness evaluations for new treatments in RR-DTC. Keywords: differentiated thyroid cancer, radioactive iodine-refractory, health-related quality of life, health utility, vignette

Olivia Thorpe, Saravana Kumar, Kylie JohnstonInternational Centre for Allied Health Evidence, The Samson Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: Chronic obstructive pulmonary disease (COPD) is characterized by a persistent blockage of airflow, prompting episodes of shortness of breath, commonly leading to hospitalization. Hospitalization may lead to a decline in physical activity following discharge. Physical activity has been shown to improve symptoms of COPD and reduce readmissions, and to decrease morbidity and mortality. This study aims to explore, from the perspectives of people with COPD, the barriers to and enablers of participation in physical activity following hospitalization for COPD.Methods: This study had a qualitative descriptive design and included semistructured interviews with 28 adult COPD patients who had been admitted to hospital with a primary diagnosis of exacerbation of COPD.Results: A plethora of barriers to but fewer enablers of participation in physical activity and pulmonary rehabilitation were identified for this cohort of people. The main barriers identified were health-related (comorbidities, COPD symptoms, and physical injury or illness) environment-related (weather, transport, and finance), and self-related. The main enabling factors reported were access to health professionals and equipment, social support, routine and extracurricular activities, personal goals and motivation, and the effect of physical activity and "feeling better".Conclusion: This research provides a snapshot of the barriers to and enablers of physical activity and pulmonary rehabilitation in people with COPD. It is evident that there are significant barriers which hinder the ability of people with COPD to undertake and continue participation in physical activity and pulmonary rehabilitation. While there are some enablers that may counter these barriers, it is clear that health professionals dealing with people suffering from COPD need to actively recognize and address barriers to physical activity and pulmonary rehabilitation. Hospital admission may create an opportunity for implementation of interventions promoting physical activity (such as referral to pulmonary rehabilitation), which may assist in reducing hospital readmission, as well as decreasing morbidity and mortality.Keywords: chronic obstructive pulmonary disease, COPD, physical activity, exercise, hospital admission, patient perspectives

Jan Heath, Karen Grimmer-Somers, Steve Milanese, Susan Hillier, Ellena King, Kylie Johnston, Kylie Wall, Olivia Thorpe, Alexandra Young, Saravana KumarSchool of Health Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: Excellence in Research for Australia (ERA) rankings are given to academic journals in which Australian academics publish. This provides a metric on which Australian institutions and disciplines are ranked for international competitiveness. This paper explores the issues surrounding the ERA rankings of allied health journals in Australia.Methods: We conducted a broad search to establish a representative list of general allied health and discipline-specific journals for common allied health disciplines. We identified the ERA rankings and impact factors for each journal and tested the congruence between these metrics within the disciplines.Results: Few allied health journals have high ERA rankings (A*/A), and there is variability in the impact factors assigned to journals within the same ERA rank. There is a small group of allied health researchers worldwide, and this group is even smaller when divided by discipline. Current publication metrics may not adequately assess the impact of research, which is largely aimed at clinicians to improve clinical practice. Moreover, many journals are produced by underfunded professional associations, and readership is often constrained by small numbers of clinicians in specific allied health disciplines who are association members.Conclusion: Allied health must have a stronger united voice in the next round of ERA rankings. The clinical impact of allied health journals also needs to be better understood and promoted as a research metric.Keywords: allied health, research impact, publication metrics

The Qweak experiment, which took data at Jefferson Lab in the period 2010 - 2012, will precisely determine the weak charge of the proton by measuring the parity-violating asymmetry in elastic e-p scattering at 1.1 GeV using a longitudinally polarized electron beam and a liquid hydrogen target at a low momentum transfer of Q2 = 0.025 (GeV/c)2. The weak charge of the proton is predicted by the Standard Model and any significant deviation would indicate physics beyond the Standard Model. The technical challenges and experimental apparatus for measuring the weak charge of the proton will be discussed, as well as the method of extracting the weak charge of the proton. The results from a small subset of the data, that has been published, will also be presented. Furthermore an update will be given of the current status of the data analysis.

A subset of results from the recently completed Jefferson Lab Qweak experiment are reported. This experiment, sensitive to physics beyond the Standard Model, exploits the small parity-violating asymmetry in elastic e→p$\vec e{\rm{p}}$ scattering to provide the first determination of the proton’s weak charge Qwp$Q_w^p$. The experiment employed a 180 μA longitudinally polarized 1.16 GeV electron beam on a 35 cm long liquid hydrogen target. Scattered electrons in the angular range 6° < θ < 12° corresponding to Q2 = 0.025 GeV2 were detected in eight Cerenkov detectors arrayed symmetrically around the beam axis. The goals of the experiment were to provide a measure of e→p$\vec e{\rm{p}}$ to 4.2% (combined statisstatistical and systematic error), which implies a measure of sin2(θw) at the level of 0.3%, and to help constrain the vector weak quark charges C1u and C1d. The experimental method is described, with particular focus on the challenges associated with the world’s highest power LH2 target. The new constraints on C1u and C1d provided by the subset of the experiment’s data analyzed to date will also be shown, together with the extracted weak charge of the neutron.

Abstract Purpose The goal of this work was to determine wall shear stress (WSS) patterns in the human abdominal aorta and to compare these patterns to measurements of intimal thickness (IT) from autopsy samples. Methods The WSS was experimentally measured using the laser photochromic dye tracer technique in an anatomically faithful in vitro model based on CT scans of the abdominal aorta in a healthy 35-year-old subject. IT was quantified as a function of circumferential and axial position using light microscopy in ten human autopsy specimens. Results The histomorphometric analysis suggests that IT increases with age and that the distribution of intimal thickening changes with age. The lowest WSS in the flow model was found on the posterior wall inferior to the inferior mesenteric artery, and coincided with the region of most prominent IT in the autopsy samples. Local geometrical features in the flow model, such as the expansion at the inferior mesenteric artery (common in younger individuals), strongly influenced WSS patterns. The WSS was found to correlate negatively with IT (r2 = 0.3099; P = 0.0047). Conclusion Low WSS in the abdominal aorta is co-localized with IT and may be related to atherogenesis. Also, rates of IT in the abdominal aorta are possibly influenced by age-related geometrical changes.

Context. The fragmentation of high-mass star-forming regions depends on a variety of physical parameters, including density, the magnetic field, and turbulent gas properties. Aims. We evaluate the importance of the density and magnetic field structures in relation to the fragmentation properties during high-mass star formation. Methods. Observing the large parsec-scale Stokes I millimeter dust continuum emission with the IRAM 30 m telescope and the intermediate-scale (<0.1 pc) polarized submillimeter dust emission with the Submillimeter Array toward a sample of 20 high-mass star-forming regions allows us to quantify the dependence of the fragmentation behavior of these regions on the density and magnetic field structures. Results. Based on the IRAM 30 m data, we infer density distributions n ∝ r−p of the regions with typical power-law slopes p around ~1.5. There is no obvious correlation between the power-law slopes of the density structures on larger clump scales (~1 pc) and the number of fragments on smaller core scales (<0.1 pc). Comparing the large-scale single-dish density profiles to those derived earlier from interferometric observations at smaller spatial scales, we find that the smaller-scale power-law slopes are steeper, typically around ~2.0. The flattening toward larger scales is consistent with the star-forming regions being embedded in larger cloud structures that do not decrease in density away from a particular core. The magnetic fields of several regions appear to be aligned with filamentary structures that lead toward the densest central cores. Furthermore, we find different polarization structures; some regions exhibit central polarization holes, whereas other regions show polarized emission also toward the central peak positions. Nevertheless, the polarized intensities are inversely related to the Stokes I intensities, following roughly a power-law slope of ∝ SI−0.62. We estimate magnetic field strengths between ~0.2 and ~4.5 mG, and we find no clear correlation between magnetic field strength and the fragmentation level of the regions. A comparison of the turbulent to magnetic energies shows that they are of roughly equal importance in this sample. The mass-to-flux ratios range between ~2 and ~7, consistent with collapsing star-forming regions. Conclusions. Finding no clear correlations between the present-day large-scale density structure, the magnetic field strength, and the smaller-scale fragmentation properties of the regions, indicates that the fragmentation of high-mass star-forming regions may not be affected strongly by the initial density profiles and magnetic field properties. However, considering the limited evolutionary range and spatial scales of the presented CORE analysis, future research directions should include density structure analysis of younger regions that better resemble the initial conditions, as well as connecting the observed intermediate-scale magnetic field structure with the larger-scale magnetic fields of the parental molecular clouds. [ABSTRACT FROM AUTHOR]

Context. The fragmentation mode of high-mass molecular clumps and the accretion processes that form the most massive stars (M ≳ 8 M⊙) are still not well understood. A growing number of case studies have found massive young stellar objects (MYSOs) to harbour disk-like structures, painting a picture that the formation of high-mass stars may proceed through disk accretion, similar to that of lower-mass stars. However, the properties of such structures have yet to be uniformly and systematically characterised. Aims. The aim of this work is to uniformly study the kinematic properties of a large sample of MYSOs and characterise the stability of possible circumstellar disks against gravitational fragmentation. Methods. We have undertaken a large observational programme (CORE) making use of interferometric observations from the Northern Extended Millimetre Array (NOEMA) for a sample of 20 luminous (L > 104L⊙) protostellar objects in the 1.37 mm wavelength regime in both continuum and spectral line emission, reaching 0.4″ resolution (800 au at 2 kpc). Results. We present the gas kinematics of the full sample and detect dense gas emission surrounding 15 regions within the CORE sample. Using the dense gas tracer CH3CN, we find velocity gradients across 13 cores perpendicular to the directions of bipolar molecular outflows, making them excellent disk candidates. The extent of the CH3CN emission tracing the disk candidates varies from 1800 to 8500 au. Analysing the free-fall to rotational timescales, we find that the sources are rotationally supported. The rotation profiles of some disk candidates are well described by differential rotation while for others the profiles are poorly resolved. Fitting the velocity profiles with a Keplerian model, we find protostellar masses in the range of ~ 10–25 M⊙. Modelling the level population of CH3CN (12K–11K) K = 0–6 lines, we present temperature maps and find median temperature in the range 70–210 K with a diversity in distributions. Radial profiles of the specific angular momentum (j) for the best disk candidates span a range of 1–2 orders of magnitude, on average ~10−3 km s−1 pc, and they follow j ∝ r1.7, which is consistent with a poorly resolved rotating and infalling envelope-disk model. Studying the Toomre stability of the disk candidates, we find almost all (11 out of 13) disk candidates to be prone to fragmentation due to gravitational instabilities at the scales probed by our observations, as a result of their high disk to stellar mass ratio. In particular, disks with masses greater than ~ 10–20% of the mass of their host (proto)stars are Toomre unstable, and more luminous YSOs tend to have disks that are more massive compared to their host star and hence more prone to fragmentation. Conclusions. In this work, we show that most disk structures around high-mass YSOs are prone to disk fragmentation early in their formation due to their high disk to stellar mass ratio. This impacts the accretion evolution of high-mass protostars which will have significant implications for the formation of the most massive stars. [ABSTRACT FROM AUTHOR]

Interactions between galaxies leave distinguishable imprints in the form of tidal features, which hold important clues about their mass assembly. Unfortunately, these structures are difficult to detect because they are low surface brightness features, so deep observations are needed. Upcoming surveys promise several orders of magnitude increase in depth and sky coverage, for which automated methods for tidal feature detection will become mandatory. We test the ability of a convolutional neural network to reproduce human visual classifications for tidal detections. We use as training ∼6000 simulated images classified by professional astronomers. The mock Hyper Suprime Cam Subaru (HSC) images include variations with redshift, projection angle, and surface brightness (μlim = 26–35 mag arcsec−2). We obtain satisfactory results with accuracy, precision, and recall values of Acc = 0.84, P = 0.72, and R  = 0.85 for the test sample. While the accuracy and precision values are roughly constant for all surface brightness, the recall (completeness) is significantly affected by image depth. The recovery rate shows strong dependence on the type of tidal features: we recover all the images showing shell features and 87 per cent of the tidal streams ; these fractions are below 75 per cent for mergers, tidal tails , and bridges. When applied to real HSC images, the performance of the model worsens significantly. We speculate that this is due to the lack of realism of the simulations, and take it as a warning on applying deep learning models to different data domains without prior testing on the actual data. [ABSTRACT FROM AUTHOR]